Kodi kufotokozera kwa acomegaly, Zizindikiro, kupewa matenda

Tikukupatsani kuti muwerenge nkhaniyi pamutuwu: "Kodi kufotokozedwa kwa acromegaly, zizindikiro, kupewa matenda" ndi ndemanga kuchokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Katswiri wathu wamtundu wa endoprinologist adzakuyankhirani.

Acromegaly - Kuchulukana kwachilengedwe mu ziwalo zina za thupi zogwirizana ndi kuchuluka kwa mahomoni amakulidwe (kukula kwa timadzi) ndi tinthu tating'onoting'ono ta anterior pituitary chifukwa cha chotupa chake. Amachitika mwa akulu ndipo amawonetsedwa ndi kukulitsidwa kwa mawonekedwe a nkhope (mphuno, makutu, milomo, chibwano chochepa), kuwonjezeka kwamapazi ndi manja, kupweteka mutu kosalekeza komanso kupweteka molumikizana, kusokoneza ntchito zakugonana ndi kubereka mwa amuna ndi akazi. Mankhwala okwera mahomoni m'magazi amayambitsa kufa koyambirira chifukwa cha khansa, m'mapapo, matenda amtima.

Kanema (dinani kusewera).

Acromegaly imayamba kukulira pambuyo pakutha kwa kukula kwa thupi. Pang'onopang'ono, pakupita nthawi yayitali, Zizindikiro zimawonjezeka, ndikusintha maonekedwe. Pafupifupi, 7ome amapezeka pambuyo pa zaka 7 kuchokera ku matendawa. Matendawa amapezeka chimodzimodzi pakati pa azimayi ndi abambo, makamaka ali ndi zaka 40-60. Acromegaly ndi njira yachilendo ya endocrine ndipo imawonedwa mwa anthu 40 pa 1 miliyoni miliyoni.

Kubisala kwa mahomoni okula (kukula kwa mahomoni, STH) kumachitika ndi gitu. Muubwana, mahomoni amakula amawongolera mapangidwe a mafupa a minofu ndi mafupa, pomwe akulu amakulamulira chakudya chamafuta, mafuta, mchere wamchere. Kubisala kwa mahomoni amakula kumayendetsedwa ndi hypothalamus, yomwe imapanga ma neurosecrets apadera: somatoliberin (imalimbikitsa kupanga GH) ndi somatostatin (ikuletsa kupanga kwa GH).

Nthawi zambiri, zinthu za somatotropin m'magazi zimasinthasintha masana, mpaka zimafika m'mawa kwambiri. Odwala omwe ali ndi acromegaly, sikuti amangowonjezera kuchuluka kwa STH m'magazi, komanso kuphwanya mtundu wabwinobwino wa chinsinsi chake. Pazifukwa zosiyanasiyana, ma cell a anterior pituitary gland samvera zowongolera zomwe zimayambitsa hypothalamus ndikuyamba kuchulukana mwachangu. Kuchulukana kwa maselo a pituitary kumabweretsa mawonekedwe a chotupa cha chosaopsa cha glandular - pituitary adenoma, yomwe imatulutsa kwambiri somatotropin. Kukula kwa adenoma kumatha kukhala masentimita angapo ndikukulitsa kukula kwa nduluyo, kufinya ndikuwononga maselo abwinobwino.

Mu 45% ya odwala omwe ali ndi acomegaly, zotupa za pituitary zimangotulutsa somatotropin, zina 30% mophatikiza zimatulutsa prolactin, mu 25% yotsalira, kuphatikiza, luteinizing, follicle-stimulating, mahomoni opatsa chithokomiro. Mu 99%, ndi pituitary adenoma yomwe imayambitsa acromegaly. Zomwe zimayambitsa kukula kwa pituitary adenoma ndizovulala zamkati, hypothalamic chotupa, kutupa kwa sinus (sinusitis). Udindo wina wake wa kukhazikika kwa hemomegaly umapatsidwa cholowa, chifukwa matendawa amawonedwa pafupipafupi ndi abale.

Muubwana ndi unyamata, motsutsana ndi kukula kwa kupitiriza, kufooka kwa STH kumayambitsa gigantism, yodziwika ndi kuchuluka kwambiri, koma kuchuluka kowonjezereka kwamafupa, ziwalo ndi minofu yofewa. Ndi kutha kwa kukula kwa thupi ndi mafupa a mafupa, kusokonezeka kwa mtundu wa acromegaly kukulitsa - kukula kwa mafupa, kuwonjezeka kwa ziwalo zamkati ndi mawonekedwe a metabolic. Ndi acromegaly, hypertrophy ya parenchyma ndi stroma yamkati: mtima, mapapu, kapamba, chiwindi, ndulu, matumbo. Kukula kwa minofu yolumikizana kumayambitsa kusintha kwa ziwalo izi, chiopsezo chotupa chotupa komanso chopweteka, kuphatikizapo cha endocrine, chikuwonjezeka.

Acromegaly imadziwika ndi njira yayitali, yamuyaya. Kutengera kuzindikirika kwa chizindikiritso cha acromegaly, pali magawo angapo:

Gawo la preacromegaly - woyamba, zizindikiro zofowoka za matendawa zimawonekera. Pakadali pano, acromegaly sichimadziwika kawirikawiri, zimangowonetsedwa ndi ziwonetsero zamagulu a kukula kwa mahomoni m'magazi komanso ndi CT yaubongo.
Hypertrophic siteji - Zizindikiro zotchulidwa za acromegaly zimawonedwa.
Gawo la tumor - zizindikiro za kuphatikizika kwa zigawo zamaubongo oyandikana (kuchuluka kwazovuta zamkati, mitsempha ndi vuto la maso) zimadza patsogolo.
Stache cachexia - kutopa monga zotsatira za acromegaly.

Kuwonetsedwa kwa acromegaly kumatha kukhala chifukwa chowonjezera kukula kwa mahomoni kapena machitidwe a pituitary adenoma pamitsempha ya Optic ndi magawo apafupi aubongo.

Kukula kwakulu kwa mahomoni kumapangitsa kusintha kwa mawonekedwe a odwala omwe ali ndi acomegaly: kuwonjezereka kwa nsagwada yam'munsi, mafupa a zygomatic, ziphuphu zapamwamba, hypertrophy ya milomo, mphuno, makutu, zomwe zimatsogolera pakuphatikizika kwa nkhope. Ndi kuwonjezeka kwa nsagwada ya m'munsi, pali kusiyana m'magawo apakati komanso kusintha kwa kuluma. Pali kuwonjezeka kwa lilime (macroglossia), komwe amalembapo zilembo zameno. Chifukwa cha kukhathamiritsa kwa lilime, zingwe zamkamwa ndi mawu, mawu amasintha - amayamba kuchepa. Zosintha maonekedwe a acromegaly zimachitika pang'onopang'ono, mosadzizunza. Pali kukula kwa zala, kuwonjezeka kwa kukula kwa chigaza, miyendo ndi manja kotero kuti wodwalayo amakakamizidwa kugula zipewa, nsapato ndi magolovesi angapo okulirapo kuposa kale.

Ndi acromegaly, kusintha kwa mafupa kumachitika: msana ukugwada, chifuwa mu kukula kwa anteroposterior chimawonjezeka, kukhala ndi mawonekedwe owumbika mbiya, malo oyambira mkati amakula. Kupanga matenda oopsa a minofu yolumikizana ndi cartilage imapangitsa kupindika komanso kuletsa kuyanjana kophatikizana, arthralgia.

Ndi acromegaly, thukuta kwambiri komanso sebumous secretion amadziwika, chifukwa cha kuchuluka kwa chiwerengerocho komanso kuchuluka kwa ntchito ya thukuta ndi zotupa za sebaceous. Khungu la odwala omwe ali ndi omegaleti, amakhuthala, ndipo amasonkhana m'makola ozama, makamaka pakhungu.

Ndi acromegaly, kuwonjezeka kwa kukula kwa minofu ndi ziwalo zamkati (mtima, chiwindi, impso) kumachitika ndikuwonjezeka pang'onopang'ono kwa dystrophy ya minofu ululu. Odwala amayamba kuda nkhawa za kufooka, kutopa, kuchepa kwapang'onopang'ono pakugwira ntchito. Myocardial hypertrophy imayamba, yomwe imasinthidwa ndi myocardial dystrophy ndikuwonjezera kulephera kwa mtima. Gawo limodzi mwa magawo atatu a odwala omwe ali ndi acomegaly amakhala ndi matenda oopsa, pafupifupi 90% amakhala ndi carotid apnea syndrome yokhudzana ndi hypertrophy ya minofu yofewa yam'mapapo kupumira komanso magwiridwe antchito a kupuma.

Ndi acromegaly, zogonana zimavutika. Amayi ambiri omwe amakhala ndi prolactin wambiri komanso akusowa kwa gonadotropins amakhala osakhudzika ndi kusabereka, galactorrhea amawoneka - kutulutsa mkaka kuchokera kunsonga, osati chifukwa cha kubereka komanso kubereka. 30% ya amuna ali ndi kuchepa kwa kugonana kwadzaoneni. Hyposecretion ya antidiuretic timadzi tokhala ndi acomegaly imawonetsedwa ndi kukula kwa matenda a shuga insipidus.

Pamene chotupa cha pituitary gland chikukula ndipo mitsempha ndi minyewa zimapanikizika, pamakhala kuwonjezeka kwa kuthinikizidwa kwa mkati, chifanizo, kuwonera kawiri, kupweteka m'masaya ndi mphumi, chizungulire, kusanza, kuchepa kumva ndi kununkhira, kunenepa kwa miyendo. Odwala ali ndi acomegaly, chiopsezo chotupa chotupa cha chithokomiro, ziwalo zam'mimba, ndipo chiberekero chikuwonjezeka.

Njira ya acromegaly imayendera limodzi ndi kukula kwa zovuta kuchokera pafupifupi ziwalo zonse. Odwala kwambiri omwe ali ndi acromegaly ndi hypertrophy ya mtima, myocardial dystrophy, matenda oopsa a mtima, kulephera kwa mtima. Oposa atatu alionse odwala amadwala matenda a shuga, chiwindi dystrophy ndi pulmonary emphysema.

Hyperproduction of kukula kwa zinthu ndi acromegaly kumabweretsa chitukuko cha zotupa zosiyanasiyana ziwalo, onse chosaopsa ndi zilonda. Acromegaly nthawi zambiri imayendera limodzi ndi kupukusa kapena nodular goiter, fibrocystic mastopathy, adenomatous adrenal hyperplasia, ma polycystic ovary, uterine fibroids, matumbo polyposis. Kupanga kuperewera kwa pituitary (panhypopituitarism) kumachitika chifukwa cha kukakamiza ndikuwonongeka kwa chotupa cha gland.

M'magawo apambuyo pake (zaka zisanu ndi zisanu ndi chimodzi kuyambira atatha matendawa), acromegaly imatha kukayikiridwa pamaziko a kuwonjezeka kwa ziwalo zamthupi ndi zizindikilo zina zakunja zomwe zimawonekera pakuwunika. Zikatero, wodwalayo amatumizidwa ndi endocrinologist kuti adziwe ngati ali ndi mayeso m'chipatala.

Njira zazikulu zoyeserera zasayansi yodziwitsa za acromegaly ndi kutsimikiza kwamisempha:

kukula kwam'mawa m'mawa ndikatha kuyesedwa kwa shuga,
IRF I - kukula kwa insulini.

Kuwonjezeka kwa kuchuluka kwa mahomoni kumatsimikiziridwa mu pafupifupi odwala onse omwe ali ndi acomegaly. Kuyesa kwamlomo ndi glucose katundu pa nthawi yacomegaly kumaphatikizapo kudziwa kufunika koyambirira kwa STH, kenako mutatha shuga - mutatha theka la ola, ola, 1.5 ndi maola awiri. Nthawi zambiri, mutatha kumwa shuga, kuchuluka kwa mphamvu ya mahoni amachepetsa, ndipo gawo lokhazikika la acromegaly, m'malo mwake, kuchuluka kwake kumadziwika. Kuyesedwa kwa glucose kumakhala kothandiza makamaka pazochitika za kuchuluka kwa STH, kapena momwe zimakhalira. Chiyeso cha glucose chimagwiritsidwanso ntchito kuwunika momwe mankhwala a acromegaly amathandizira.

Kukula kwa mahomoni kumachitika mthupi kudzera mu zinthu zomwe zimapanga insulini (IRF). Kuchuluka kwa plasma IRF I ndikuwonetsa kutulutsidwa kwathunthu kwa GH patsiku. Kuwonjezeka kwa IRF I m'magazi a munthu wamkulu kukuwonetsa mwachindunji kukula kwa acromegaly.

Kuunika kwamaso kwa odwala omwe ali ndi acromegaly kumachepetsa mawonekedwe owoneka, popeza njira zowoneka bwino zimapezeka muubongo pafupi ndi gitu. Pamene radiography ya chigaza iwulula kuwonjezeka kwa kukula kwa chishalo cha Turkey, komwe kuli pituitary gland. Kuwona chotupa cha pituitary, diagnostics apakompyuta ndi MRI yaubongo amachitidwa. Kuphatikiza apo, odwala omwe ali ndi acomegaly amawunikira zovuta zosiyanasiyana: matumbo a polyposis, matenda a shuga mellitus, goiter yama multinodular, etc.

Mu acromegaly, cholinga chachikulu cha chithandizo ndikupeza chikhululukiro cha matendawa pochotsa matenda a somatotropin hypersecretion ndikusintha ndende ya IRF I. Pochizira acromegaly, endocrinology yamakono imagwiritsa ntchito njira zamankhwala, opaleshoni, ma radiation ndi njira zophatikizira.

Kusintha mtundu wa somatotropin m'magazi, makonzedwe a somatostatin analogues amalembedwa - neurosecret ya hypothalamus, yomwe imachepetsa kubisalira kwa kukula kwa mahomoni (octreotide, lanreotide). Ndi acromegaly, kuyika kwa mahomoni ogonana, dopamine agonists (bromocriptine, kabergoline) akuwonetsedwa. Pambuyo pake, nthawi imodzi ya gamma kapena mankhwala a radiation nthawi zambiri amachitidwa pa gland.

Ndi acromegaly, chothandiza kwambiri ndikuchotsa chotupacho m'munsi mwa chigaza kudzera m'mafupa a sphenoid. Ndi adenomas ang'onoang'ono atachitidwa opaleshoni, 85% ya odwala asintha kukula kwa mahomoni ndi kupitiliza kukhululuka kwa matendawa. Ndi chotupa chachikulu, kuchuluka kwa kuchiritsa chifukwa cha ntchito yoyamba kumafika 30%. Chiwopsezo cha kufa kwa chithandizo cha opaleshoni cha acomegaly chimachokera ku 0.2 mpaka 5%.

Kuperewera kwa mankhwala a acromegaly kumabweretsa kulumala kwa odwala omwe ali ndi zaka zambiri zogwira ntchito, kumawonjezera chiopsezo cha kufa msanga. Ndi acromegaly, chiyembekezo cha moyo chimachepa: 90% ya odwala sakhala ndi moyo mpaka zaka 60. Imfa nthawi zambiri imachitika chifukwa cha matenda amtima. Zotsatira za chithandizo cha opaleshoni ya acomegaly zimakhala bwino ndi zazikulu zazing'ono za adenomas. Ndi zotupa zazikulu za pituitary gland, kufupika kwa kubwereranso kwawo kumawonjezeka kwambiri.

Pofuna kupewa aceromegaly, kuvulala kumutu kuyenera kupewedwa, ndipo matenda oyamba ndi matenda a nasopharyngeal ayenera kutsukidwa. Kuzindikira koyambirira kwa acromegaly ndi matenda a kukula kwamagulu am'magazi kungathandize kupewa zovuta komanso kuchititsa kuti matendawa asachiritsidwe.

Muzu umayambitsa ndi magawo a acromegaly

Tizilombo touluka timatulutsa timadzi tantheticrop (STH), yomwe imayambitsa kukhazikitsidwa kwa mafupa a minofu ndi mafupa muubwana, ndipo akuluakulu amayang'anira kagayidwe kamchere wamadzi.

Odwala okhala ndi acomegaly, pali kuphwanya kapangidwe ka timadzi timeneti ndi kuwonjezereka kwa kuchuluka kwake m'magazi. Pituitary adenoma yokhala ndi acromegaly imachitika ndi kukula kwama cell a pituitary.

Malinga ndi akatswiri, choyambitsa matenda ambiri a acromegaly ndimateni a adenoma, omwe amatha kupanga pamaso pa zotupa za hypothalamic, kuvulala pamutu, komanso matenda osachiritsika. Udindo wofunikira pakukula kwa acromegaly umaseweredwa ndi cholowa.

Acromegaly imadziwika ndi njira yayitali, mawonekedwe ake amatengera gawo la chitukuko:

Preacromegaly imadziwika ndi kuwonjezeka pang'ono pamlingo wa GH, chifukwa chomwe palibe chizindikiro chowonetsera cha matenda,

Hypertrophic siteji - zizindikiro zotchulidwa za matendawa zimawonedwa,

Gawo la chotupa limadziwika ndi kuwonjezeka kwa kukakamiza kwachuma komanso kusokonezeka kwa magwiridwe antchito amawonedwe amanjenje.

Cachexia - kukopa kwa odwala kumawonedwa.

Chifukwa chachitukuko chazitali gawo loyambirira la acomegaly, palibe zizindikiro zakunja zomwe zimawonedwa.

Mawonetseredwe azachipatala

Zizindikiro za acromegaly mwa ana ndi akulu zimaphatikizapo:

Zowawa pamsana ndi mafupa chifukwa chakukhazikika kwawo ndikukula kwa arthropathy,

Kuchepetsa tsitsi kwa akazi,

Kukula kwa malo pakati pa mano, kuchuluka kwa nkhope zosiyanasiyana, khungu lake.

Maonekedwe a zophukira zamkati,

Kukula kwa chithokomiro,

Kuchepetsa mphamvu yogwira ntchito, kutopa,

Kukula kwa mtima ndi ma pathologies omwe angayambitse imfa,

Kukula kwa matenda ashuga

Kusweka kwa khungu pakhungu,

Kusokonezeka kwa dongosolo la kupuma.

Ndi pituitary acromegaly, kuphatikizika kwa maselo athanzi kumachitika, komwe kumakwiyitsa:

Akucheperachepera mphamvu ndi libido mwa amuna,

Kusabereka, kusamba kwa akazi,

Ma pafupipafupi migraines omwe sangathe kulandira chithandizo chamankhwala.

Kuzindikira

Kuzindikira kwa acromegaly ndi gigantism ndikotheka pamaziko a data: MRI yaubongo, Zizindikiro, radiograph ya phazi, paramu ya biochemical.

Pakati pa maphunziro a labotale, kutsimikiza kwa kuchuluka kwa STH ndi kukula kwa insulin-1 kumasiyanitsidwa. Nthawi zambiri, mulingo wa STH sioposa 0.4 μg / l, ndipo IRF-1 imafanana ndi zodziwika bwino molingana ndi jenda komanso zaka za phunzirolo. Ndi zopatuka, kukhalapo kwa matendawa sikungathetsedwe.

Radiography ya phazi imagwira ntchito kuti iwone ngati matupi ake anali ofewa. Mfundo zam'manja mwa amuna mpaka 21 mm, mwa akazi - mpaka 20 mm.

Ngati matendawa adakhazikitsidwa kale, kafukufuku wa pathogenesis wa acromegaly ndi kutsimikiza kupatuka mu pituitary ndi hypothalamus.

Anapangidwa tomography a m'chiberekero ziwalo, chifuwa, retroperitoneum, ziwalo zam'mimba ikuchitika popanda kukhalapo pituitary pathologies ndi kukhalapo kwa zamankhwala amuzolengedwa ndi matenda zikuwonekera za matenda acomegaly.

Zochita zochizira za acomegaly

Cholinga chachikulu cha njira zochiritsira zamatenda amtunduwu ndikupangitsa matendawa kukula, kutanthauza kuti kumabweretsa chikhululukiro.

Mwa izi, njira zotsatirazi zimagwiritsidwa ntchito:

Mankhwala othandizira opaleshoni amagwiritsidwa ntchito m'njira ziwiri: transcranial and transgenic. Chisankho chimapangidwa ndi neurosurgeon. Opaleshoni imagwira ntchito yochotsa micadenomas kapena pang'ono mbali ya macroadenomas.

Kuwonetsa pangozi kumachitika pokhapokha pakutha kuchitidwa opaleshoni, chifukwa mipeni ya gamma iyi, mtengo wozungulira, othandizira mzere angagwiritsidwe ntchito.

Mankhwala, magulu otsatirawa a mankhwalawa amagwiritsidwa ntchito: somatotropic hormone antagonists, somatostatin analogues, dopaminergic mankhwala.

Njira yophatikiza ya mankhwalawa imagwiritsidwa ntchito molingana ndi malingaliro a dokotala.

Kusankha kwa njira zochizira kuyenera kuchitika molumikizana ndi katswiri yemwe waphunzira pathogenesis ya acromegaly, zizindikiro ndi zotsatira za maphunziro a biochemical a wodwalayo.

Malinga ndi ziwerengero, opaleshoni imawonedwa ngati yothandiza kwambiri, pafupifupi 30% ya omwe amachitidwa opaleshoni yonse, ndipo ena onse amakhala ndi nthawi yopumira.

Pazifukwa zodzikongoletsera tikulimbikitsidwa:

Kuthandiza pa nthawi yake matenda okhudzana ndi nasopharynx,

Pewani kuvulala kumutu.

Ngati zizindikiro zilizonse zokayikitsa zichitika, pezani upangiri wa endocrinologist. Sikoyenera kudziyimitsa pawokha komanso makamaka kuchitira.

Mawonetseredwe azachipatala a acromegaly amayamba chifukwa cha kuchuluka kwa mahomoni okula, mahomoni ena okula omwe amapangidwa ndi pituitary gland, kapena matenda omwe amachititsa kukula kwa zotupa (ma pituitary adenomas, zotupa muubongo, metastases ochokera ku ziwalo zakutali).

Zomwe zimayambitsa kukula kwa matendawa ndizochulukitsa cha mahomoni a somatotropic, omwe makamaka amakhala mwachilengedwe, kapena ali ndi chiyambi cha hypothalamic.

Zimavomerezedwa kuti njira ya pathological yomwe imayamba m'mimba, mwayi mu nthawi yaunyamata, imatchedwa gigantism. Chizindikiro cha gigantism mwa ana ndikukula kwachangu komanso kwamphamvu kwa ziwalo, minofu, mafupa am'mimba, kusintha kwa mahomoni. Momwemonso zomwe zimachitika pambuyo pakutha kwa kukula kwa thupi, pakukula kwambiri kumatchedwa acromegaly. Zizindikiro zokhudzana ndi acromegaly zimawerengedwa kuti ndizowonjezereka mwa ziwalo, minofu ndi mafupa amthupi, komanso kukula kwa matenda a concomitant.

Zizindikiro za gigantism mwa ana

Zizindikiro zoyambira za acromegaly (gigantism) mwa ana zimatha kupezeka patapita nthawi kuchokera pa nthawi yomwe akukula. Kunja, amawonetsedwa ndikukula kwamiyendo ndi miyendo, yomwe imayamba kuzimiririka ndipo imamasuka. Nthawi yomweyo, mutha kuzindikira kuti mafupa a zygomatic, maukonde apamwamba amawonjezeka, pamakhala kupindika kwa mphuno, pamphumi, lilime ndi milomo, chifukwa chomwe mawonekedwe amaso amasintha, ndikukhala ouma.

Zosokoneza zamkati zimadziwika ndi edema mumapangidwe ammero ndi zamphongo, zomwe zimapangitsa kusintha kwamphamvu kwa mawu, kumapangitsa kutsika. Odwala ena amadandaula kuti akwapula. Mu chithunzichi, acromegaly mwa ana ndi achinyamata akuwonekera ndi kukula kwakukulu, ziwalo zopanda thupi zopanda thupi, miyendo yolumikizidwa chifukwa cha kukula kwa mafupa. Kukula kwa matendawa kumayendera limodzi ndi kusintha kwa mahomoni, zomwe ndi:

Hypersecretion of the sebaceous gland,

kuchuluka kwa magazi

calcium yambiri ya mkodzo

mwayi wokhala ndi matenda a ndulu,

chithokomiro edema ndi opuwala ntchito.

Nthawi zambiri kuubwana, mawonekedwe owonjezereka a minofu yolumikizidwa imawonedwa, omwe amachititsa mawonekedwe a chotupa komanso kusintha kwamkati: mtima, chiwindi, mapapu, matumbo. Nthawi zambiri mumatha kuwona chithunzi cha ana akhanda omwe ali ndi khosi acromegaly, gawo lomwe limakulitsa minofu ya sternocleidomastoid.

Zizindikiro za Acromegaly mwa Akuluakulu

Hyperproduction of grow ukuaji imayambitsa zovuta mu thupi la munthu wamkulu, zomwe zimapangitsa kuti asinthe mawonekedwe ake, omwe amatha kuwonekera bwino mu chithunzi chake kapena munthu. Monga lamulo, izi zimawonekera pakukula kwakusiyana kwa ziwalo zina za thupi, kuphatikiza miyendo ndi manja, manja, miyendo ndi chigaza. Monga ana, mwa odwala akuluakulu, pamphumi, mphuno, milomo, nsidze, mafupa a zygomatic, kusintha kwamkono kwa nsagwada, chifukwa komwe madera apakati amakula. Odwala ambiri ali ndi macroglossia, omwe amakulitsa lilime.

Zizindikiro za acromegaly, zomwe zimayambitsidwa nthawi zambiri ndi pituitary adenoma mwa akuluakulu, zimaphatikizapo kufooka kwa mafupa, makamaka, kupindika kwa msana, kukulitsa pachifuwa, ndikutsatiridwa ndi kufalikira kwa malo oyambira, komanso kusintha kwa malo olumikizirana mafupa. Hypertrophy ya cartilage ndi minofu yolumikizana imabweretsa kuchepa kwa mgwirizano wophatikizika, zomwe zimayambitsa arthralgia.

Nthawi zambiri odwala amadandaula chifukwa cha kupweteka kwa mutu pafupipafupi, kutopa, kufooka kwa minofu, kuchepa kwa magwiridwe antchito. Izi zikuchitika chifukwa cha kukula kwa minofu ndikusintha kwa minofu ya minofu. Nthawi yomweyo, kuwoneka kwa myocardial hypertrophy, kudutsa mu myocardial dystrophy, ndikupangitsa kukula kwa kulephera kwa mtima, ndizotheka.

Odwala omwe ali ndi zizindikiro za acromegaly zomwe zikupita patsogolo nthawi zambiri amawonetsedwa kusintha kwa mawonekedwe awo omwe amawapangitsa kufanana. Komabe, ziwalo zamkati ndi machitidwe zimasinthanso. Chifukwa chake mu azimayi kusamba kumaphwanyidwa, kusabereka kumayamba, galactorrhea - kutulutsidwa kwa mkaka kuchokera kunsonga popanda kutenga pakati. Odwala ambiri, ngakhale ali ndi zaka komanso zaka zambiri, amapezeka kuti ali ndi vuto la kugona tulo.

Ngati sanachiritsidwe, monga lamulo, matchulidwewo amakhalabe okhumudwitsa. Kupita patsogolo kwa matenda am'matumbo kumabweretsa kulumala kwathunthu, komanso kumawonjezera chiopsezo cha kufa msanga komwe kumachitika chifukwa cha matenda a mtima. Kutalika kwa moyo wa odwala omwe ali ndi matenda acomegaly kumachepetsedwa kwambiri ndipo sikufika zaka 60.

Zizindikiro

Kuzindikira acromegaly ndikosavuta, makamaka m'magawo apambuyo, chifukwa mawonekedwe ake akunja ali achindunji. Komabe, pali gulu linalake la matenda, zomwe zizindikiro zake zimafanana kwambiri ndi zizindikiro za acromegaly. Kuti mupeze matenda osiyanasiyana ndikutsimikizira (kapena kupatula) kukhalapo kwa acromegaly, kufunsa kwa endocrinologist kumayikidwa, komanso njira zowoneka, zasayansi ndi zothandizira kuzindikira matenda a acromegaly.

Kuyang'ana wodwalayo

Asanafotokozere njira zoyenera zodziwira matenda ndi kulandira chithandizo choyenera, dokotala amatenga anamnesis, kuti adziwitsenso tsogolo lakukhazikika kwa matendawa, ndipo amachititsanso kafukufuku - palpation, percussion, auscultation. Kutengera ndi zotsatira za kufufuza koyambirira, njira zoyenera zodziwira matenda zimayikidwa.

Njira zothandizira matenda

Pozindikira matenda a acromegaly, mayeso amakalabu achilengedwe amagwiritsidwa ntchito: kuyezetsa magazi ndi mkodzo. Komabe, zothandiza kwambiri ndipo motero zomwe zimagwiritsidwa ntchito nthawi zambiri zimawerengedwa kuti ndi tanthauzo la mahomoni m'magazi omwe ali ndi acromegaly: STH - hormone ya kukula kwa somatotropic, ndi insulin-like grow factor - IGF-1.

Kuwona mulingo wa STH

Kutsimikizika kwa chitukuko cha gigantism kapena acromegaly ndizowonjezereka za somatotropin m'magazi - kukula kwa mahomoni, omwe amapangidwa ndi gulant pituitary gland. Mbali yodziwika yopanga STH ndi mtundu wa cyclical, motero, kukayezetsa kuti mudziwe kuchuluka kwake, zitsanzo zingapo zamagazi zimachitidwa:

poyambirira, kuyesedwa kwamphindi atatu kumachitika ndi mphindi 20., pambuyo pake seramu imasakanikirana ndipo pafupifupi STH imatsimikizika,

lachiwiri, kuyeza magazi kasanu-kawiri kumachitika ndi kupatula kwa maola 2,5, koma mulingowo umatsimikiziridwa pambuyo polandila gawo lililonse la magazi. Chizindikiro chomaliza chimapezedwa ndikuwongolera mfundo zonse.

Kutsimikizika kwa matenda a acromegaly kumatha ngati kuchuluka kwa mahomoni kupitirira 10 ng / ml. Matendawa amatha kupatulidwa ngati mtengo wapakati sudapitirira 2,5 ng / ml.

Kudziwitsa za IGF-1

Kuyesa kwina kopindulitsa ndi kutsimikiza kwa mulingo wa mahomoni IGF-1. Ili ndi kukhudzika kwambiri komanso kutsata kwake, chifukwa sikumatengera kusinthasintha kwa kabulidwe, ngati mahormone okula. Ngati mulingo wa IGF-1 m'magazi upitilira momwemo, adokotala amatha kudziwa kuti ali ndi magazi m'thupi. Komabe, kuyesaku kuyenera kuchitika molumikizana ndi maphunziro ena, chifukwa phindu la IGF-1 lingasiyane mothandizidwa ndi zina:

Kuchepetsa vuto la chiwindi, matenda oopsa, kuchepa kwa mphamvu, kufa ndi njala,

kuchuluka chifukwa cha kusintha kwa ma hormone, komanso kuwonjezeka kwamankhwala a insulin m'magazi.

Mayeso a kulolera a glucose

Pazotsatira zokayikitsa, kuyesa kudziwa STH pogwiritsa ntchito shuga kumachitika pofuna kufotokoza bwino za matendawo. Mwa mayendedwe ake, gawo loyambira la mahomoni okula limayesedwa, kenako wodwalayo amafunsidwa kuti atenge njira yothetsera shuga. Pakusowa kwa acomegaly, kuyesa kwa shuga kumawonetsa kuchepa kwa chinsinsi cha STH, ndipo ndi kukula kwa matendawa, m'malo mwake, kuchuluka kwake.

CT kapena MRI

Njira yayikulu komanso yophunzitsira yodziwitsa anthu matendawa ndi CT kapena MRI, yomwe imakulolani kuti muzindikire adenoma ya pituitary, komanso kuchuluka kwake kufalikira kumadera ndi ziwalo. Ndondomeko imachitika pogwiritsa ntchito wothandizira yemwe amasonkhana mu minofu yosinthika, yomwe imathandizira njira yophunzirira ndikukulolani kuti muwone kusintha kwa pituitary kapena hypothalamus.

Pokonza njira zodziwitsa, odwala ambiri ali ndi chidwi ndi momwe MRI imayenera kuchitidwira ndi acromegaly. Njirayi nthawi zambiri imachitika pa gawo la hypertrophy ya ziwalo za thupi, kusintha maonekedwe a chipatala, ndipo pambuyo pake, pachiwopsezo cha chotupa, pomwe wodwalayo akudandaula chifukwa cha kutopa kwambiri, kupweteka kwa mutu, kupweteka kwa minofu ndi kuphatikizika, komanso mawonetsedwe ena okhudzana.

X-ray ya chigaza

Njirayi ikuchitika pofuna kuzindikira mawonekedwe a radiome ofotokoza, komanso zizindikilo za kakulidwe ka pituitary adenoma:

kuchuluka kwa chishalo cha Turkey,

kuchuluka kwa mphulupulu,

Pokonzekera radiology kumayambiriro kwa matendawa, zizindikiro izi zimatha kusapezeka, motero, njira zina, zothandizira, njira zowunikira zimayikidwa:

radiography ya mapazi, yomwe imakupatsani mwayi kuti muwone kukula kwa minofu yofewa m'derali,

kuyesedwa ndi ophthalmologist kuti adziwe edema, stasis ndi optic atrophy, zomwe nthawi zambiri zimayambitsa khungu.

Ngati ndi kotheka, wodwalayo adapangidwa kuti ayesedwe kuti adziwe zovuta: shuga, matumbo polyposis, nodular goiter, adrenal hyperplasia, etc.

Acromegaly amatanthauza matenda omwe chithandizo chake sichitha pambuyo pake. Kupanga kwambiri mahomoni okula kumatha kubweretsa kulumala koyambirira ndikuchepetsa mwayi wokhala ndi moyo wautali. Ngati muli ndi zizindikiro zoyambirira, muyenera kufunsa dokotala. Ndi dokotala wokha atatha mayeso onse omwe amatha kudziwa matendawa ndikuwapatsa chithandizo choyenera.

Zolinga ndi Njira

Zolinga zazikulu za chithandizo cha acomegaly ndi:

kutsika kobisika kwa kukula kwa mahomoni (mahomoni okula),

kuchepa kwa kutulutsa insulin-IGF-1,

kutsitsa kwa pituitary adenoma,

Mankhwalawa amachitika motere:

Pambuyo pa maphunziro azachipatala, dokotala amasankha njira yoyenera kwambiri, poganizira matendawo komanso momwe wodwalayo alili. Nthawi zambiri, mankhwala a acromegaly, omwe amafunikira njira yokwanira, amachitika mokwanira, kuphatikiza njira zosiyanasiyana.

Zambiri

Opaleshoni

Chithandizo chothandiza kwambiri cha acromegaly chimawonedwa ngati opaleshoni yochotsa pituitary adenoma. Madokotala amalimbikitsa opaleshoni kwa onse a microadenoma ndi macroadenoma. Ngati chotupa chikukula msanga chikadziwika, opareshoni ndi mwayi wokhazikika.

Opaleshoni imachitidwa m'njira imodzi mwanjira ziwiri:

Njira zochepa zowukira. Chotupacho chimachotsedwa msanga popanda kuwonongeka m'mutu ndi craniotomy. Opaleshoni yonse imagwiritsidwa ntchito kudzera pakutsegulira kwammphuno pogwiritsa ntchito zida za endoscopic.

Njira yopondera. Njira yochita opareshoniyi imagwiritsidwa ntchito pokhapokha ngati chotupa chafika pakukula kwakukulu ndikuchotsa adenoma kudzera pamphuno. Onse opareshoni ndi nthawi yokonzanso zovuta ndizovuta, chifukwa craniotomy imachitidwa.

Nthawi zina acromegaly imabweranso opaleshoni. Chotupacho chaching'onoting'ono, nthawi zambiri ndizotheka kuti nthawi yokumukhululuka imatenga nthawi yayitali. Kuti muchepetse zowopsa, ndikofunikira kukayezetsa magazi munthawi yake.

Mankhwala

Madokotala amapereka mankhwala othandizira matenda.Mwanjira ya monotherapy, mankhwala amalembedwa kawirikawiri, chifukwa amathandizira kuchepetsa kupanga mahomoni opanga kukula, koma sangathe kuchiritsa matendawa kwathunthu.

Nthawi zambiri, mankhwalawa amapatsidwa mankhwala ngati awa:

Ngati opereshoni sanatulutse zotsatira,

Ngati wodwala akukana kulandira opaleshoni,

ngati pali ma contraindication opaleshoni.

Kumwa mankhwala kumathandizira kuchepetsa chotupacho, kotero nthawi zina mankhwala amapatsidwa mankhwala asanapange opaleshoni.

Mankhwala a acromegaly, mankhwala a magulu otsatirawa amagwiritsidwa ntchito:

somatostatin analogues (octreodite, lantreoditis),

kukula kwama hormone receptor blockers (pegvisomant).

Kumwa mankhwala kumachitika pokhapokha malinga ndi dokotala. Kudzichiritsa nokha, komanso wowerengeka azitsamba kumatha kukulitsa matendawa.

Chithandizo cha poizoniyu

Mankhwala othandizira poizoniyu sagwiritsidwa ntchito kawirikawiri mankhwalawa a acromegaly, chifukwa amakhala ndi zovuta pafupipafupi - kukulitsa kwa hypopituitarism. Mavuto amatha kuchitika patatha zaka zingapo atachiritsidwa. Kuphatikiza apo, zotsatira zake nthawi zambiri mukamagwiritsa ntchito njirayi sizimachitika mwachangu.

Njira zotsatirazi zochiritsira radiation zikugwiritsidwa ntchito pano:

Kugwiritsa ntchito mankhwala a radiation kumayendera limodzi ndi mankhwala.

Matendawa akuti acromegaly matenda amatanthauza kuti ndi matenda omwe amapezeka mwa munthu yemwe walephera kukula kwa timadzi tomwe timapanga timadzi tomwe timapanga kukula, komwe ndiko kuwonetsa kwa ntchito yopanga kubereka kwamakulidwe a mahomoni pambuyo pake. Zotsatira zake, kuchuluka kwa kukula kwa mafupa onse, ziwalo zamkati ndi ziwalo zofewa za thupi zimaphwanyidwa (izi zimachitika chifukwa chosungidwa ndi nayitrogeni m'thupi). Acromegaly imatchulidwa makamaka pamiyendo ya thupi, nkhope ndi mutu wonse.

Matendawa amapezeka mwa azimayi ndi abambo onse kumaliza nthawi yakukula. Kuchulukana kwa matendawa kukuchokera kwa anthu 45-70 pa miliyoni imodzi. Thupi la mwana silimakhudza matendawa. Nthawi zina, mwa ana omwe akukula, kuchuluka kwamafuta amakula kumabweretsa mkhalidwe wotchedwa gigantism. Kusintha koteroko kumakhala kodziwika chifukwa chakulemera kwambiri komanso kukula kwa mafupa.

Popeza acomegaly siofala kwambiri, ndipo matendawa amachoka pang'onopang'ono, sizivuta kuzindikira matendawo kale.

Zonsezi zimayambitsidwa osati chifukwa chophwanya mahomoni akukula, komanso kusintha kwa zina zanthupi ntchito:

Kuchepa kwa adrenal cortex.

Chifukwa cha acromegaly, kagayidweko kamasokonezedwa, komwe nthawi zambiri kumayambitsa matenda a shuga komanso kumakhala ndi chiopsezo chachikulu ku moyo wa munthu. Koma musakhumudwe, pali machitidwe ena azachipatala omwe angathandize kwambiri kuchepetsa zizindikiro ndikuchepetsa kupititsa patsogolo kwa acromegaly.

Zizindikiro za acromegaly ndikuwonetsa pang'onopang'ono komanso moonekera bwino pakukula kwa matenda. Matendawa amachitika chifukwa cha kusalingana kwa ma horoni mwa kusintha kwa maonekedwe, komanso kuwonongeka m'moyo wabwino. Pali odwala omwe azindikiritsa izi pokhapokha zaka 10. Madandaulo akuluakulu a odwala ndikuwonjezereka kwa auricles, mphuno, miyendo ndi miyendo.

Pakupanga nkhondo yolimbana ndi matendawa, pali zotsatira ziwiri zazikulu: neoplasms yoyipa ndi matenda a mtima. Pali njira zinayi zazikulu zochizira matendawa:

Njira yopangira opaleshoni. Madokotala oyenerera amachotsa zotupazo kwathunthu. Njira iyi imakuthandizani kuti mupeze zotsatira zake mwachangu. Pali zovuta zina pambuyo pa opaleshoni.

Chithandizo cha radiation kapena radiation. Nthawi zambiri, njira imeneyi imagwiritsidwa ntchito pochitapo opaleshoni sinathandize. Komanso, irradiation imakhala ndi zolakwika zina zofufuzira: mitsempha ya optic imakhudzidwa, chotupa cha ubongo chachiwiri.

Njira yamankhwala. Acromegaly amathandizidwa ndi mitundu itatu ya mankhwalawa:

Analogs of FTA (wokhala ndi nthawi yayitali (Samatulin ndi Sandostatin LAR) komanso wocheperako - Sandostatin Octroedit).

Dopamine agonists (mankhwala a ergoline ndi nonergoline).

Kuphatikizidwa. Chifukwa cha njirayi, chithandizo chabwino kwambiri chimapezeka.

Koma zokumana nazo zikuwonetsa kuti madokotala amatsatirabe zamankhwala. Njirayi imakhala ndi zotsatira zoyipa mthupi la munthu.

Mndandanda wamankhwala othana ndi zotsatira za acromegaly ndiwokwanira:

Genfastat ndi mankhwala akunyumba.

Octride ndi othandizira a mucolytic.

Sandotatin - Beta - Adrenergic blocker.

Samatulin ndiwotsutsa.

Mwa ambiri mwa mankhwalawa, chinthu chogwira ntchito ndi octreodite. Mlingo uliwonse ndi ma regimens othandizira amathandizidwa ndi adokotala okha.

Zofunika kukumbukira mukamagwiritsa ntchito wowerengeka azitsamba pochiza acromegaly

Zothandiza kulimbitsa thupi ndikufulumizitsa kuchira kumakhala mankhwala ndi zipatso zakonzedwe kuchokera kuzomera ndi zitsamba monga:

licorice ndi ginseng muzu

Acromegaly, wowerengeka azitsamba zochizira zomwe zimagwiritsidwa ntchito pokhapokha povomerezana ndi adokotala, ndizothandiza kwambiri. Kumbukirani kuti infusions ndi tiyi kuchokera ku zitsamba siziyenera kusungidwa kwanthawi yayitali. Iyenera kugwiritsidwa ntchito mkati mwa maola 24 mut kulowetsedwa ndi kupsinjika.

Izi ndichifukwa choti ngati atayimirira nthawi yayitali, ataya machiritso onse, machitidwe obwezeretsa komanso, choipitsitsa, atha kuyipsa kwambiri. Mankhwalawa a acromegaly ndi maphikidwe a wowerengeka, izi sizovomerezeka, chifukwa vuto lililonse lingasokoneze thupi ndi ntchito ya chithokomiro cha chithokomiro, yomwe yapatsidwa gawo limodzi mwamaudindo akuluakulu pankhaniyi.

Gawo lokakamiza, lomwe limafunikanso kugwirizanitsidwa ndi katswiri, ndikuthandizira pakudya. Zimakupatsani mwayi wolimbitsa thupi, kufulumizitsa metabolism ndikuwonjezera kuchuluka kwa kukana kwa thupi.

Maphikidwe omwe amapemphedwa kwambiri

Ngati muli ndi acromegaly, maphikidwe a wowerengeka azithandiza kuyimitsa zina mwa matendawa. Chimodzi mwa maphikidwe otchuka kwambiri ndi kuphatikiza kwa njere za maungu, udzu woyamba, grated mizu ya ginger, nthangala za sesame ndi 1 tsp. wokondedwa. Osakaniza woperekedwa uyenera kugwiritsidwa ntchito kwa 1 tsp. kanayi pa tsiku. Ngati atatha masiku 14-16 osasinthika momwe mungagwiritsire ntchito mankhwalawa, ndikofunikira, mutakambirana ndi endocrinologist, kusintha kapangidwe kake kapena kukana kugwiritsa ntchito mankhwalawa.

Kubwezeretsa ndi maphikidwe a fodya wa azidole akuphatikizira kuphatikiza mitengo ya chomera. Mankhwala omwe amapezeka ndi monga:

Kuphatikiza mbewu (osachepera 10 g.) Yotengedwa mu 200 ml. madzi otentha. Kuti mugwiritse ntchito mankhwala omwe mukufunikira muyenera 40-50 ml. musanadye ndipo izi ziyenera kuchitidwa kangapo 4 pasanathe maola 24.

Dziwani kuti kugwiritsa ntchito mankhwala azisamba ndi maphikidwe pochiza acromegaly ndiyothandiza. Izi ndichifukwa cha zabwino pa endocrine gland. Komabe, kutsindika kwakukulu pa chithandizo cha acomegaly kuyenera kuchitika osati kokha pamankhwala, komanso pa kugwiritsa ntchito mankhwala, njira zopangira opaleshoni pakuchira. Ndi kuphatikiza koyenera kwa njira zomwe zaperekedwa, zotsatira zake zidzakhala 100%.

Kodi acomegaly ndi chiyani?

Popanga mahomoni okula, gawo laubongo - pituitary gland - limayang'anira. Nthawi zambiri, mahomoniwa amapangidwa mwa ana kuyambira tsiku loyamba la moyo, amathandizidwa mwamphamvu kwambiri nthawi yakutha msinkhu, pamene kuchuluka kwa kukula kumatha kufika mpaka 10 cm m'miyezi ingapo. Mbali iyi ikamalizidwa, somatotropin imachepetsa zochitika zake: madera okulira amayandikira pafupifupi zaka 15-17 kwa akazi ndi 20-22 kwa amuna.

Acromegaly - Ichi ndi mkhalidwe wamavuto omwe kukula kwa mahomoni akupitilizidwa kupanga bwino mu akulu. Pali nthawi zina pomwe zimayambanso kuthandizira odwala omwe amapanga kale omwe kale anali abwinobwino.

Kukula kwa mahormoni sikulekeratu kupangidwa ndi gustine pituitary gland mwa akulu.

Hormone iyi imasungidwa komanso yabwinobwino, yoyang'anira:

kagayidwe kazakudya - amateteza kapamba, kuyang'anira shuga,
mafuta kagayidwe - kuphatikiza mahomoni ogonana amawongolera magawidwe a mafuta amkati,
madzi mchere kagayidwe - amakhudza ntchito ya impso, diuresis.

Gland "yamchiberekero" imagwira ntchito limodzi ndi gawo lina la ubongo - hypothalamus. Otsatirawa ali ndi udindo wobisika wa somatoliberin, womwe umalimbikitsa kuwonjezeredwa kwa somatotropic kupanga ndi somatostatin - motero, zoletsa mopitilira muyeso komanso osalola zotsatira zoyipa kwambiri pakhungu la anthu.

Kuyerekeza kumeneku kumatha kukhala kwamunthu aliyense malinga ndi mtundu wake, chikhalidwe chake, jenda, zaka, komanso zokhudzana ndi thanzi. Chifukwa chake, pafupifupi, nkhope zamtundu wa ku Europe ndizokwera kuposa oyimilira anthu aku Asia, amuna amakhala ndi mikono ndi miyendo yayitali kuposa azimayi, etc. Zonsezi zimawerengedwa ngati zosiyananso ndi zina zonse.

Mukamayankhula za acromegaly, zimatanthawuza kusokonezeka kwa matenda a hypothalamus ndi gitu. Pali zifukwa zambiri, koma kuwunikaku kungapangike potsatira zotsatira za kusanthula, komwe kumaphatikizapo kuchuluka ndi nthawi yobisika ya mahomoni okula kuphatikiza IRF I, kukula kwa insulini.

Acromegaly ndi matenda a akulu, omwe kale anali athanzi. Ngati Zizindikiro zikukula kuyambira ubwana, ndiye kuti mikhalidwe imayitanidwa gigantism.

Ma pathologies onsewa samangokhudza kwambiri mawonekedwe a munthu. Iwo ali kuyambitsa zovuta zambiriZina mwazoti kutopa, chiyembekezo cha khansa yamtundu winawake, ndi zotsatirapo zina zowopsa.

Njira yodziwira ndi nthawi yodziwira matendawa imathandizira kupewa matendawa, kupewa mavuto obwera chifukwa cha thanzi ndi moyo. Njira zimayenera kutengedwa pakukayikira koyamba kwa matenda amtundu wa endocrine, nthawi zina, kutengera zifukwa, zikhale zotheka kuti zizichotsa zizindikirazo.

Zoyambitsa Acromegaly

Makina onse opanga chitukuko cha maselo a acromegaly ndi chinsinsi cholakwika cha kukula kwa mahomoni, omwe amachititsa kuchuluka kwa maselo.

Zina mwazomwe zimayambitsa ndi izi:

Zotupa za Benign, monga lamulo, adenomas a pituitary amakhala chifukwa chachindunji cha acomegaly oposa 90% a milandu. Gigantism ya ana imagwirizananso ndi matenda amodzimodzi, chifukwa ma neoplasms nthawi zambiri amakula mwa mwana adakali achichepere kapena asanakwanitse zaka zaunyamata.
Ma tumor ndi ma pathologies ena a hypothalamus, omwe amachititsa kuti pakhale kusowa kwa mahomoni omwe amalepheretsa chinsinsi cha kukula kwa mahomoni, kapena, mosiyana, amachititsa kuti gland ya pituitary ipange kuchuluka kwazinthu. Ichi ndiye chifukwa chachiwiri chazikulu kwambiri cha acromegaly.
Choyambitsa matendawa chomwe chimayambitsa matendawa nthawi zambiri chimavulala mu chigaza, ubongo, kuphatikizapo kupindika. Kugwetsa kapena kuwonongeka kumachitika, komwe kumapangitsa ma cysts kapena zotupa. Mbiri yakale ya odwala ambiri achikulire omwe ali ndi vuto la kukomoka, kuvulala pamutu koopsa komanso kuuma kwambiri.
Kupititsa patsogolo kwa IGF, komwe kungathenso kuphatikizidwa ndi zotupa, ma pathologies a horoni system, chiwindi. Mapuloteni pawokha amapangidwa ndi hepatocytes, koma zomwe zimapezeka m'magazi zimatha kutengera zinthu zingapo - insulin, zomwe zili mu testosterone ndi estrogen, ndi ntchito ya chithokomiro cha chithokomiro.
Nthawi zina, pamakhala chodabwitsa cha kubisala kwa ectopic wa mahomoni ena a ziwalo - chithokomiro, thumba losunga mazira, ma testicles. Izi sizomwe zimachitika kawirikawiri, komanso zimapezeka mwa odwala omwe ali ndi acomegaly ndi gigantism.

Mutha kuzindikira kale matenda koyambirirazosintha zazing'ono zikayamba. Mwa munthu wamkulu, maonekedwe amasintha mwachangu, ndikupanga chithunzi cha matenda. Pankhani ya mwana yemwe akuyembekezeredwa gigantism, kuyezetsa kwathunthu kwa mwana ndi endocrinologist, neuropathologist ndi akatswiri ena ndikofunikira.

Chithandizo cha Acromegaly

Monga matenda onse a endocrine, acromegaly sagwidwa bwino. Chifukwa chake, kudziwitsidwa koyambilira ndi njira zodziwira matenda ndizofunikira, zomwe zimalola kudziwika kwa nthawi yayitali ya matenda komanso kupewa kupezeka kwa zovuta zazikulu. Pakadali pano, kuchira kwathunthu ndi wodwala kubwerera ku boma matenda asanafike ndimaonedwa ngati osowa, koma angathe kuchitidwa kuti matendawa apitirire.

Kuchita bwino kwa achire kwatsimikizira:

Kuthandizira opaleshoni - kuchotsedwa kwa ma pituitary adenomas, zotupa za hypothalamus ndi ma neoplasms ena mu ubongo omwe amakhudza kupanga kwa mahomoni okula. Tsoka ilo, njirayi sioyenera nthawi zonse, nthawi zina kukula kwa chotupa kumakhala kochepa kwambiri, koma kumapitilizabe kukhudza gawo lowonekera la ubongo.
Chithandizo cha poizoniyu - Amabwera m'malo mwa opaleshoni, ngati palibe njira yochotsa chotupacho mwachindunji. Mothandizidwa ndi radiation yapadera, ndizotheka kukwaniritsa kusinthika kwa neoplasm, kuchepa kwake. Kuthetsa chithandizo: Kuleza mtima ndi wodwala, sikuti nthawi zonse kumakhala kofunikira.
Phwando STH secretion inhibitors, imodzi mwazomwe amadziwika ndi Sandostatin. Kusankhidwa kwa mankhwalawa kuyenera kuchitika ndi endocrinologist, komanso mlingo, regimen ya mankhwala.
Gawo lofunikira lothandizira odwala omwe ali ndi patsogolo ometi ma pinkiller, chondroprotectors ndi othandizira ena omwe amathandizira kuchepetsa mawonetsedwe a matendawa.

Ndi matenda oyamba ndi kusakhalapo kwa zovuta zazikulu, zotsatira zabwino zimatha, mpaka kubwerera kwa wodwalayo kukhala ndi moyo wabwinobwino. Kuphatikiza apo, odwala amalembedwa matenda a shuga a mellitus prophylaxis, zakudya zopatsa mphamvu zapamwamba kwambiri, omwe amathandiza kupatsa thupi chakudya chokwanira, koma kuchuluka kwa glucose ndi shuga, chifukwa thupi limalekerera.

Zomwe zimayambitsa matendawa

Choyambirira chachikulu cha kukhazikika kwa acromegaly ndikuphwanya kwa chida cha pituitary, chomwe chikufotokozedwa mwachinsinsi kwambiri cha somatropin (kukula kwa mahomoni). Ali mwana, timadzi timeneti timalimbikitsa kukula kwa mafupa a mwana, ndipo mwa akulu amakongoletsa chakudya chamafuta ndi mafuta. Ndi acromegaly, maselo a pituitary pazifukwa zosiyanasiyana amagwira ntchito mopanda kuyankha kuzizindikiro zamthupi (izi zimachitika nthawi zambiri ndi matenda otupa).
Zomwe zimayambitsa chitukuko cha matendawa ndi monga:

Pituitary adenoma, yomwe imakwiyitsa secretion ya mahomoni ena.

Kusintha kwathanzi lakutsogolo kwa lobe ya hypothalamus.
Kuchuluka kwamphamvu kwa thupi lathu kuti likulitse mahomoni.
Heredity, kukhalapo kwa matenda a samatotrophinomas.
Kapangidwe ka ma cysts mu ubongo, kukula komwe kumayamba chifukwa cha kuvulala kwa ubongo kapena matenda otupa.
Kupezeka kwa zotupa mthupi.

Magawo a Acromegaly Development

Matendawa amadutsa madigiri atatu a matenda:

Gawo loyamba ndi preacromegalic. Pakadali pano, palibe zomwe zimayambitsa matendawa, chifukwa chake ndizosatheka kuzindikira ndipo titha kuwapeza mwamwayi panthawi yoyesedwa kwathunthu kuchipatala.
Gawo la hypertrophic limadziwika ndi kuwonetsa koyamba kwa zizindikiro, kusintha kwakunja m'thupi. Pakadali pano, chotupacho chimakula kukula ndikuwonetsa zizindikiro: chiwonetsero champhamvu cha intracranial, kuchepa kowonekera m'maso, kufooka kwathunthu kwa thupi.
Gawo la cachectal ndilo gawo lomaliza la matendawa, pomwe kutsika kwa thupi kumawonedwa, mitundu yambiri yamavuto imayamba.

Kupewa matenda

Pofuna kupewa kukhazikika kwa pituitary acromegaly, ndikofunikira kutsatira njira zosavuta zotetezera:

Pewani craniocerebral kapena kuvulala kumutu kwina.
Pewani kukula kwa matenda otupa a muubongo (mwachitsanzo, meningitis).
Nthawi ndi nthawi mumatenga mayeso a labotale kuti mukukula mahomoni m'magazi.
Yang'anirani mosamala thanzi la kupuma komanso kuchita kukonzanso kwakanthawi.

Acromegaly - zithunzi, zomwe zimayambitsa, zizindikiro zoyambirira, zizindikiro ndi chithandizo cha matendawa

Acromegaly ndi matenda a m'magazi omwe amapita patsogolo chifukwa chophatikizidwa ndi pituitary gland ya somatotropin pambuyo pochulukitsa kwa epiphyseal cartilage. Nthawi zambiri, acromegaly imasokonezedwa ndi gigantism. Koma, ngati gigantism imachitika kuyambira ubwana, ndi akuluakulu okha omwe ali ndi vuto la acromegaly, ndipo mawonekedwe owoneka amawonekera patatha zaka 3-5 atatha kugwira ntchito mthupi.

Acromegaly ndi matenda omwe amapanga kukula kwa mahomoni (kukula kwa mahomoni), pomwe pali kuphwanya kwa kuchuluka kwa mafupa ndi ziwalo zamkati, kuphatikiza apo, pali vuto la metabolic.

Somatropin imakulitsa kapangidwe kazakapangidwe kazakudya zomanga thupi, pomwe ikugwira ntchito zotsatirazi:

Imachepetsa kuwonongeka kwa mapuloteni,
imathandizira kusintha kwa maselo amafuta,
amachepetsa mawonekedwe a minofu yamafuta m'matumbo amkati,
kumawonjezera pakati pa minofu ndi adipose minofu.

Ndikofunikira kudziwa kuti mulingo wa mahomoni umatengera ziwonetsero zaka, chifukwa chake kuchuluka kwadzaoneni kwa somatropin kumawonedwa m'zaka zoyambirira za moyo mpaka pafupifupi zaka zitatu, ndipo kupanga kwake kwakukulu kumachitika muunyamata. Usiku, somatotropin imachulukitsidwa kwambiri, kotero kusokonezeka kwa kugona kumayambitsa kuchepa kwake.

Zimachitika kuti ndimatenda amanjenje omwe amakhudza pituitary gland, kapena pazifukwa zina, zolakwika zamthupi ndi mahomoni a somatotropic amapangidwa mopambanitsa. Mu chikhomo cholimira, chimachulukitsidwa kwambiri. Ngati izi zidachitika mu ukalamba, pamene madera okula achangu atatsekedwa kale, izi zikuwopseza ndi acromegaly.

Mu 95% ya milandu, chifukwa cha acromegaly ndi chotupa cha m'mimba - adenoma, kapena somatotropinoma, yomwe imapereka katulutsidwe kakang'ono ka kukula kwa mahomoni, komanso kulowa kwake kosagwirizana m'magazi

Monga lamulo, acromegaly imayamba pambuyo pakuvulala kwamanjenje yapakati, matenda ake opatsirana komanso osapatsirana. Udindo wina wakukula umapatsidwa kubadwa kwa makolo.

Acromegaly imayamba pang'onopang'ono, chifukwa chake, zizindikiro zake zoyambirira nthawi zambiri sizimadziwika. Komanso, izi ndizovuta kwambiri pakuzindikira koyambira kwa matenda am'mimba.

Chithunzichi chikuwonetsa chizindikiro cha acromegaly pankhope

Akatswiri amawunikira zizindikiro zazikuluzikulu za pituitary acromegaly:

kupweteka mutu pafupipafupi, kawirikawiri chifukwa cha kukakamizidwa kwa intracranial,
mavuto a kugona, kutopa,
Photophobia, kumva kusamva,
chizungulire nthawi zina,
Kutupa kwa miyendo ndi nkhope,
kutopa, ntchito yochepa,
kupweteka kumbuyo, kulumikizana, kuchepa kwa mphamvu yogwirizana, dzanzi la miyendo,
thukuta

Kukula kwambiri kwa mahomoni kumapangitsa kuti masinthidwe osintha a odwala omwe ali ndi acomegaly:

Kutontheka kwa lilime, tinthu tokhala ngati mankhwalawa ndi phokoso kumayambitsa kuchepa kwa mawu - amayamba kukhala ogontha, kuwonjezereka.
Kukula kwa mafupa a zygomatic
nsagwada yapansi
nsidze
Hypertrophy yamakutu
mphuno
milomo.

Izi zimapangitsa nkhope kukhala yolimba.

Mafupa ndi opunduka, pali kuwonjezeka pachifuwa, kukulira kwa malo oyambira, msana ukugwada. Kukula kwa cartilage ndi minofu yolumikizana kumayambitsa kusuntha kwamalumikizidwe, kupindika kwake, kupweteka kwapawiri kumachitika.

Chifukwa cha kuchuluka kwa ziwalo zamkati kukula ndi kuchuluka, minyewa ya wodwala imakulirakulira, zomwe zimatsogolera kukuwoneka ngati kufooka, kutopa, ndi kuchepa msanga kwa ntchito. Hypertrophy ya minofu ya mtima ndi kulephera kwa mtima kumapita patsogolo mwachangu.

Acromegaly imadziwika ndi njira yayitali, yamuyaya. Kutengera kuzindikirika kwa chizindikiritso cha acromegaly, pali magawo angapo:

Preacromegaly - imadziwika ndi zizindikiro zoyambirira, imapezeka kawirikawiri, popeza sizisonyezo sizokwanira kutchulidwa. Komabe, pakadali pano, ndizotheka kuzindikira za ecomegaly mothandizidwa ndi compact tomography ya bongo, komanso kuchuluka kwa timadzi tomwe timapanga kukula m'magazi,
Hypertrophic siteji - Zizindikiro zotchulidwa za acromegaly zimawonedwa.
Tumor: imadziwika ndi zisonyezo zowonongeka ndi kuwonongeka kwa zida zomwe zili pafupi. Izi zitha kukhala kuphwanya magwiridwe antchito a ziwalo zamasomphenya kapena kukhathamira kwa intracranial.
Gawo lomaliza ndi gawo la cachexia, limayendera limodzi ndi kutopa chifukwa cha acromegaly.

Tengani mayeso onse azachipatala anthawi yake kuti muthandizire kuzindikira matendawa.

Kuopsa kwa acromegaly mu zovuta zake, zomwe zimawonedwa pafupifupi ziwalo zonse zamkati. Mavuto wamba:

mavuto amanjenje
matenda a endocrine dongosolo,
mastopathy
zotupa za uterine,
polycystic ovary syndrome,
matumbo a m'mimba
matenda amtsempha wamagazi
kulephera kwa mtima
ochepa matenda oopsa.

Khungu limakhala ndi izi:

kupindika kwa khola la pakhungu,
warts
seborrhea,
thukuta kwambiri
hydradenitis.

Ngati zizindikiro zoyambirira zikuwoneka kuti zikuimira acromegaly, muyenera kulankhulana ndi dokotala woyenera kuti mumupezere ndi matenda anu. Acromegaly imapezeka pamaziko a deta yoyesa magazi pamlingo wa IRF-1 (somatomedin C). Pazikhalidwe zabwino, kuyesedwa koyeserera koonjezera shuga. Pazifukwa izi, wodwala wokhala ndi akaloza odziwika amayesedwa mphindi 30 zilizonse kanayi pa tsiku.

Kuti muwonetsetse ndikuwonetsetsa ndikuyambitsa zomwe zimayambitsa:

Kusanthula magazi ndi mkodzo kambiri.
Kuyesa kwamwazi wamagazi.
Ultrasound ya chithokomiro England, thumba losunga mazira, chiberekero.
X-ray ya chigaza ndi dera la chishalo cha Turkey (kupangika kwa mafupa mu chigaza kumene kuli pituitary gland) - kuwonjezeka kwa kukula kwa chishalo cha Turkey kapena kudutsa.
CT scan ya pituitary gland ndi ubongo ndi kuvomerezedwa mosiyana kapena MRI popanda kusiyanitsa
Kufufuza kwa Ophthalmological (kuyesa kwa maso) - mwa odwala padzakhala kuchepa kwa kuwona kwa chidwi, kuletsa kwamawonedwe.
Kuphatikiza koyerekeza kwa zithunzi za wodwala pazaka zisanu ndi zitatu zapitazi.

Nthawi zina madokotala amakakamizika kugwiritsa ntchito njira zochizira opaleshoni ya acomegaly. Nthawi zambiri zimachitika ngati chotupacho chitafika zokulira zazikulu ndikumakanikizira minofu yaubongo.

Mankhwala osokoneza bongo a pituitary acromegaly amapezeka mukugwiritsa ntchito mankhwala omwe amalepheretsa kupanga mahomoni okula. Masiku ano, magulu awiri a mankhwala amagwiritsidwa ntchito pa izi.

Gulu limodzi - ma analogu a somatostin (Sandotastatin, Somatulin).
Gulu lachiwiri ndi dopamine agonists (Parloder, Abergin).

Ngati adenoma afika pakukula kwakukulu, kapena ngati matendawo akupita patsogolo, chithandizo chamankhwala chokhacho sichingakhale chokwanira - pankhaniyi, wodwalayo akuwonetsedwa chithandizo chamankhwala opangira opaleshoni. Ndi zotupa zochulukirapo, opaleshoni yachiwiri imachitika. Nthawi yomweyo, gawo la chotupa chomwe chimapezeka mu cranium limachotsedwa koyamba, ndipo patatha miyezi ingapo, zotsalira za pituitary adenoma kudzera pamphuno zimachotsedwa.

Chizindikiro chachindunji cha opaleshoni ndikutha msanga kwamaso. Chotupacho chimachotsedwa kudzera fupa la sphenoid. Mu 85% ya odwala, atachotsa chotupa, kuchepa kwakukulu kwa msana wa kukula kwa mahomoni kumadziwikiridwa mpaka kuzowonekera kwa zizindikiro ndi chikhululukiro chokhazikika cha matendawa.

Chithandizo cha radiation cha acomegaly chimawonetsedwa pokhapokha ngati pakuchitapo kanthu opaleshoni ndizosatheka komanso chithandizo chamankhwala sichithandiza, chifukwa pambuyo pochitidwa chifukwa cha kuchedwa, kuchotsedwa kumachitika pokhapokha patatha zaka zochepa, ndipo chiopsezo chokhala ndi kuvulala kwa radiation ndi chambiri kwambiri.

Kukula kwa matendawa kumadalira nthawi komanso kulondola kwa chithandizo. Kusakhalapo kwa njira zochotsera omegaleti zimatha kubweretsa kulemala kwa odwala omwe akugwira ntchito komanso okalamba, komanso zimawonjezera chiopsezo cha kufa.

Ndi acromegaly, chiyembekezo cha moyo chimachepa: 90% ya odwala sakhala ndi moyo mpaka zaka 60. Imfa nthawi zambiri imachitika chifukwa cha matenda amtima. Zotsatira za chithandizo cha opaleshoni ya acomegaly zimakhala bwino ndi zazikulu zazing'ono za adenomas. Ndi zotupa zazikulu za pituitary gland, kufupika kwa kubwereranso kwawo kumawonjezeka kwambiri.

Kupewa kwa acromegaly kumapangidwira kuzindikira koyambirira kwa kusokonezeka kwa mahomoni. Ngati munthawi yotithandizira kukula kwachulukidwe ka mahomoni ofunikira, mutha kupewa kusintha kwa ziwalo zamkati ndi mawonekedwe, kuchititsa kukhululukirana.

Kupewera kumaphatikiza kutsatira zotsatirazi:

Pewani kuvulala kwambiri pamutu,
funsani dokotala zamatenda a metabolic,
Samalani matenda omwe amakhudza ziwalo zam'mapazi,
Chakudya cha ana ndi akulu chizikhala chokwanira ndipo chizikhala ndi zinthu zonse zofunika zofunikira.

Acromegaly ndi matenda a pituitary gland omwe amaphatikizidwa ndi kuchuluka kwa mahomoni okula - somatotropin, omwe amadziwika ndi kukula kwa mafupa ndi ziwalo zamkati, kukulitsa mawonekedwe a nkhope ndi mbali zina za thupi, kusokonekera kwa metabolic. Matendawa amapangitsa kuti ziwoneka bwino ngati kukula kwakhazikika kwa thupi kwatatha. Poyambirira, kusintha kwazomwe zimayambitsa ndikuwonekeratu kapena ayi. Acromegaly imapita patsogolo kwa nthawi yayitali - Zizindikiro zake zimachulukana, ndipo kusintha maonekedwe kumadziwika. Pafupifupi, zaka zisanu ndi ziwiri mpaka zisanu kuchokera ku chiyambi cha matenda oyamba kuzindikira.

Anthu okalamba ali ndi vuto la acromegaly: monga lamulo, munthawi ya zaka 40-60, amuna ndi akazi.

Zotsatira za somatotropin pa ziwalo ndi minofu ya anthu

Kubisala kwa kukula kwa mahomoni - kukula kwa mahomoni - kumachitika ndi gitu. Imayendetsedwa ndi hypothalamus, yomwe, ngati pakufunika, imatulutsa ma neurosecretions somatostatin (amaletsa kupanga kwa mahomoni okula) ndi somatoliberin (imayambitsa).

Mthupi la munthu, mahomoni okula amapereka mawonekedwe a kukula kwa mafupa a mwana (mwachitsanzo, kukula kwake m'litali) ndipo amayang'anira kupangidwe koyenera kwa minofu ndi mafupa.

Akuluakulu, somatotropin amatenga kagayidwe - imakhala ndi tanthauzo la anabolic, imalimbikitsa njira zama protein, zimathandizira kuchepetsa kuyika kwa mafuta pansi pa khungu komanso kumapangitsanso kuyaka kwake, kumakulitsa kuchuluka kwa minofu kukhala mafuta. Kuphatikiza apo, timadzi timeneti timakonzanso kagayidwe kazakudya, kamakhala gawo limodzi la mahomoni a contra-mahomoni, i.e, kukulitsa kuchuluka kwa shuga m'magazi.

Pali umboni kuti zotsatira za kukula kwa mahomoni zimapangitsanso mphamvu komanso kuwonjezeka kwa calcium ndi minofu yamafupa.

Zomwe zimayambitsa ndi njira za acromegaly

Mu 95% ya milandu, chifukwa cha acromegaly ndi chotupa cha m'matumbo - adenoma, kapena somatotropinoma, yomwe imapereka secretion yowonjezera kukula kwa mahomoni. Kuphatikiza apo, matendawa amatha kuchitika ndi:

matenda a hypothalamus, kupangitsa kuchuluka kwa somatoliberin,
kuchuluka kwa insulini-kukula,
Hypersensitivity ya minofu kukula mahomoni,
katulutsidwe katulutsidwe a kukula kwa mahomoni mu ziwalo zamkati (mazira, mapapo, bronchi, ziwalo zam'mimba thirakiti) - ectopic secretion.

Monga lamulo, acromegaly imayamba pambuyo pakuvulala kwamanjenje yapakati, matenda ake opatsirana komanso osapatsirana.

Zimatsimikiziridwa kuti omwe ali ndi matenda amtunduwu amavutikanso ndi acomegaly pafupipafupi.

Kusintha kwa morphological mu acromegaly kumadziwika ndi hypertrophy (kuchuluka kwa kuchuluka ndi unyinji) wa ziwalo zamkati, kukula kwa minofu yolumikizana mwa iwo - kusintha kumeneku kumawonjezera mwayi wokhala ndi vuto loopsa komanso loyipa m'thupi la wodwalayo.

Zizindikiro zake za matendawa ndi:

kukulitsa manja, miyendo,
kuwonjezeka kwa kukula kwa mawonekedwe a nkhope - nsidze zazikulu, mphuno, lilime (pali zipsinjo za mano), zotulutsira kunja kwa nsagwada, ming'alu imawoneka pakati pa mano, khola pamphumi ,
mawu akumva
mutu
paresthesia (kumverera kwa dzanzi, kumva kuwawa, kukwawa m'malo osiyanasiyana a thupi),
kupweteka kumbuyo, mafupa, kuchepa kwa mphamvu yogwirizana,
thukuta
Kutupa kwa miyendo ndi nkhope,
kutopa, ntchito yochepa,
chizungulire, kusanza (ndi chizindikiro cha kuchuluka kwa kuthina kwa chotupa ndi chotupa chachikulu)
dzanzi la miyendo
kusamba kwa msambo
kuchepa kuyendetsa zogonana ndi potency,
kuwonongeka kwamaso (kuwona kawiri, mantha a kuwala kowala),
kusamva ndi kumva kununkhira,
kutha kwa mkaka kuchokera ku mabere am'mimba - galactorrhea,
kupweteka kwakanthawi.

Kafukufuku wofunsidwa wa munthu yemwe ali ndi vuto la acromegaly, dokotala adzazindikira zosintha izi:

Ndiponso, adotolo adzataya chidwi pakukula kwa mawonekedwe ndi mawonekedwe a miyendo,
kufooka kwa mafupa mafupa (kupindika kwa msana, mawonekedwe a mbiya - kuwonjezeredwa mu kukula kwa anteroposterior - chifuwa, malo owonjezereka),
kutupa kwa nkhope ndi manja,
thukuta
hirsutism (kukula kwa tsitsi la amuna mu akazi),
kuchuluka kwa chithokomiro, mtima, chiwindi ndi ziwalo zina.
proximal myopathy (i.e., kusintha kwa minofu yomwe ili pafupi ndi pakati pa thunthu),
kuthamanga kwa magazi
miyeso pa electrocardiogram (zizindikiro za mtima wotchedwa acromegaloid),
kuchuluka kwa prolactin m'magazi,
kagayidwe kachakudya matenda (mu kotala odwala pali zizindikiro za matenda a shuga, okhazikika (osakhazikika, osaganizira) kwa hypoglycemic mankhwala, kuphatikizapo kuperekera insulin.

Mwa odwala 9 mwa 10 omwe ali ndi acomegaly mu gawo lake lotukuka, zizindikiro za usiku ziphuphu zakumaso zimadziwika. Chofunikira cha matendawa ndikuti chifukwa cha kupanikizika kwa minofu yofewa ya chapamwamba kupumira komanso kuperewera kwa malo opumira mwa anthu, kumangidwa kwakanthawi kochepa kumachitika nthawi yogona.Wodwala iyemwini, monga lamulo, samawakayikira, koma abale ndi abwenzi a wodwalayo alabadira chizindikiro ichi. Amazindikira kukokomeza usiku, komwe kumasokonezedwa ndi kupuma, komwe nthawi zambiri kupuma kwa chifuwa cha wodwalayo kulibe. Izi zimapuma kwakanthawi, kenako wodwalayo modzidzimutsa. Pali kudzutsidwa kambiri usiku kuti wodwalayo asagone mokwanira, amadzimva kuti ali ndi nkhawa, mtima wake umayamba kuwawa, amakhala wosakwiya. Kuphatikiza apo, pamakhala chiopsezo cha kufa kwa wodwala ngati m'modzi mwa iwo akupuma akuchedwa.

Mukuyamba kumene kwa chitukuko, acromegaly sizimabweretsa vuto kwa wodwalayo - odwala osamala kwambiri samazindikira msanga kuchuluka kwa gawo limodzi kapena gawo lina la thupi. Matendawa akamakula, zizindikirizo zimayamba kutchulidwa, pamapeto pake pali zizindikiro za mtima, chiwindi ndi kulephera m'mapapo. Odwala otere, chiopsezo chotenga matenda a atherosulinosis, matenda oopsa ndi dongosolo la kukula kwambiri kuposa kwa anthu omwe alibe vuto la acromegaly.

Ngati pituitary adenoma ikukula mwa mwana pomwe madera akukulidwa mafupa ake adakali otseguka, amayamba kukula mwachangu - matendawa amadzionetsa ngati gigantism.

Kufotokozera mwachidule za matenda

Acromegaly amakula, monga lamulo, ndi chotupa neoplasms kutulutsidwa mu anterior pituitary gland, yomwe imayambitsa kupanga kwa kukula kwa mahomoni. Odwala omwe ali ndi matenda amtunduwu, mawonekedwe a nkhope amasintha (khalani akulu), manja ndi kukula kwa miyendo. Kuphatikiza apo, njira ya pathological imayendera limodzi ndi kupweteka kwapweteka ndi mutu, pali zosemphana ndi njira yolerera.

Ndikofunikira! Matendawa, monga acromegaly, amakhudza okhawo odwala akuluakulu. Matenda achiberekero amayamba kukula mukamaliza kutha ndi kukula kwa thupi!

Malinga ndi ziwerengero, odwala azaka zapakati pa 40 mpaka 60 amakhudzidwa kwambiri ndi acromegaly. Njira ya pathological imadziwika ndi pang'onopang'ono, mochedwa. Nthawi zambiri, matendawa amapezeka pambuyo pa zaka 6-7 kuyambira pachiyambi cha kukula kwake, komwe kumapangitsa kuti pakhale chithandizo chotsatira.

Madokotala amasiyanitsa magawo otsatirawa a chitukuko cha pathological process:

Pachigawo choyamba, matendawa amapitilira mawonekedwe obisika, osinthika, ndipo kusintha kumatha kuonekera pokhapokha poganiza zaubongo.
Pakadali pano, chizindikiro cha pathology chimadziwoneka bwino kwambiri.
Gawo lachitatu, pali kuwonjezeka kwa chotupa neoplasm yomwe ili mu gululi wa anterior pituitary gland. Nthawi yomweyo, magawo aubongo oyandikana nawo amakakamizidwa, zomwe zimayambitsa kuwonetsa kwa zizindikiro zenizeni, monga kuwonongeka kwa mawonekedwe, kusokonezeka kwa mitsempha, komanso kuwonjezeka kwa kukakamizidwa kwa intracranial.
Gawo lachinayi lomaliza la acromegaly limadziwika ndi chitukuko cha cachexia ndi kutsiriza kwathunthu kwa thupi la wodwalayo.

Kuchulukitsa kwa mahomoni amakula kumalimbikitsa kukhazikika kwa matenda amtima, mapapu ndi matenda a oncological, omwe nthawi zambiri amayambitsa imfa ya odwala omwe ali ndi vuto la acromegaly.

Kuneneratu komanso kupewa kwa acomegaly

Popanda chithandizo, matendawa ndi osauka, odwala amakhala ndi moyo zaka zitatu kapena zisanu, wobadwira gigantism, anthu samakhala ndi moyo mpaka makumi awiri asanafike mankhwala apakhungu. Njira zamakono zitha kulepheretsa kupangika kwa mahomoni okula kapena kuchepetsa chidwi cha thupi kwa icho. Nthawi zina amachotsa chotupacho kwathunthuicho chakhala choyambitsa. Chifukwa chake, ndimankhwala oyenera, matendawa amatha kukhala ndi moyo zaka 30, koma chithandizo chokhazikika chimafunikira. Odwala ambiri ali ndi zilema zochepa.

Kupewa kwa matenda osowa komanso ovuta ngati amenewa ndiwopupuluma, chifukwa palibe chifukwa chimodzi chazomwe zimapangidwira. Malangizo ochokera kwa madotolo akhoza kukhala upangiri pewani kuvulala kumutu, komanso kwa iwo omwe ali ndi vuto la kukhumudwa, pitani kwa a psychologist ndi endocrinologist kwazaka zingapo pambuyo pangozi, yomwe ikupatsani mwayi wazidziwitso kusintha kwa pituitary gland koyambirira.

Limagwirira chitukuko ndi zimayambitsa aceromegaly

Mavuto a Acromegaly

Kodi matenda amatsenga ndi oopsa?

Kuphatikiza pa kuti acomegaly yokha imawononga mawonekedwe a wodwalayo komanso imachepetsa kwambiri moyo wake, popanda chithandizo choyenera, matenda amtunduwu amathanso kukulitsa zovuta zowopsa.

Nthawi zambiri, njira yodziwika bwino yokhala ndi acomegaly imawoneka ngati matenda otsatirawa:

zovuta zam'mimba
mavuto amanjenje
matenda a endocrine dongosolo,
adrenal hyperplasia
ma fibro
matumbo a m'mimba
kusabereka
nyamakazi ndi arthrosis,
matenda amtsempha wamagazi
kulephera kwa mtima
ochepa matenda oopsa.

Chonde dziwani:Pafupifupi theka la odwala omwe ali ndi acomegaly amakhala ndi zovuta monga matenda a shuga.

Kuphwanya mawonekedwe owoneka ndi machitidwe amtunduwu kungayambitse ugonthi wathunthu komanso khungu la wodwalayo. Komanso, zosintha izi sizingasinthike!

Acromegaly imachulukitsa zovuta zomwe zimawoneka ngati zotupa zolakwika neoplasms, komanso ma pathologies osiyanasiyana a ziwalo zamkati. Vuto lina lowopsa la acromegaly ndi kupuma kwamatenda am'mimba, omwe amapezeka nthawi yayikulu kugona.

Ichi ndichifukwa chake wodwala amene akufuna kupulumutsa moyo wake, pamene zizindikilo zoyambirira zomwe zimafotokoza za acromegaly zimawonekera, ayenera kufunafuna thandizo kuchokera kwa katswiri woyenera - katswiri wa endocrinologist!

Momwe mungadziwire matendawa?

Nthawi zambiri, katswiri amatha kukayikira kupezeka kwa acromegaly kale pamawonekedwe a wodwalayo, zizindikiro zake komanso pakusanthula kwa mbiri yomwe yatenga. Komabe, kuti adziwe zoyenera, azindikire gawo la momwe matenda amawonongera komanso kuchuluka kwa zowonongeka zamkati, odwala amatumizidwa mayeso otsatirawa:

Ndikofunikira! Njira yayikulu yodziwitsira matenda ndikuwonetsa kukula kwa mahomoni pogwiritsa ntchito shuga. Ngati chida cha pituitary chikugwira ntchito moyenera, glucose amathandizira kuchepa kwamlingo wa kukula, mwanjira ina, kuchuluka kwa mahomoni, kumawonjezeka.

Kuti muzindikire zovuta zomwe zimakhumudwitsidwa ndi chitukuko cha acromegaly, njira zowunikira zowonjezereka zimachitika:

Pambuyo pakufufuza mozama, katswiri sangangopanga chidziwitso cholondola, komanso kudziwa kukhalapo kwa matenda ophatikizika, omwe amalola kuti wodwalayo apatsidwe njira yochiritsira yolondola kwambiri yotsimikizika pamlandu winawake!

Njira Zochizira Acromegaly

Ntchito yayikulu ya madotolo pozindikira syntomegaly ndikupeza chikhululukiro chokhazikika, komanso kusintha momwe amapangira kukula kwa mahomoni.

Njira zotsatirazi zitha kugwiritsidwa ntchito pazolinga izi:

kumwa mankhwala
mankhwala a radiation
opareshoni.

Ndikofunikira! Nthawi zambiri, kulimbana ndi matendawa kumadalira mankhwala osokoneza bongo.

Njira zopumira

Pofuna kuponderezana kwambiri kukula kwa timadzi timene timatulutsa timadzi tambiri, odwala amathandizidwa kudziwa njira yothandizira mahomoni pogwiritsa ntchito ma enifesito anthitoatinat. Nthawi zambiri odwala amapatsidwa mankhwala monga Bromocriptine, omwe cholinga chake ndi kupanga dopamine, yomwe imaletsa kaphatikizidwe ka mahomoni somatotropin.

Pamaso pa zovuta zovuta ndi matenda ophatikizika, chithandizo choyenera chothandizira chikuchitika, njira yomwe imapangidwira wodwala aliyense payekhapayekha.

Kugwiritsa ntchito mankhwala a radiation kwawonetsa zotsatira zabwino.. Njirayi ndi yomwe imapangitsa gawo lowonongeka la chida cha pituitary ndi ma ray ena a gamma. Malinga ndi ziwerengero komanso mayeso azachipatala, kugwiritsa ntchito njirayi ndi pafupifupi 80%!

Njira imodzi yamakono kwambiri yodziwongolera ometiacitis ndi radiotherapy. Malinga ndi akatswiri, kuchuluka kwa mafunde a x-ray kumathandizira kuti kuponderezana kwamphamvu kwa kukula kwa zotupa neoplasms komanso kupanga mahomoni okula. Njira yonse ya chithandizo chamankhwala a x-ray imakupatsani mwayi wokhazikika wodwalayo ndikuchotsa chizindikiro chokhala ndi mawonekedwe a acromegaly, ngakhale mawonekedwe a wodwalayo amawonekera pang'onopang'ono!

Opaleshoni ya Acromegaly

Kuthandizira kwa opaleshoni ya acomegaly kumasonyezedwa kukula kwakakulu kwa chotupa neoplasms, kupita patsogolo kwamatenda a pathological, komanso pokhapokha pakuchitika kwa njira zowongolera zamankhwala.

Ndikofunikira! Kuchita opaleshoni ndi njira imodzi yothandiza kwambiri yodziwirira. Malinga ndi ziwerengero, 30% ya odwala omwe adachitidwa adachiritsidwa kwathunthu kumatenda, ndipo mwa 70% ya odwala pali kukhululukidwa kwanthawi yayitali!

Kuchitapo kanthu kwa opaleshoni ya acomegaly ndi opareshoni yochotsa pituitary tumor neoplasm. Nthawi zovuta kwambiri, kuchitanso opareshoni yachiwiri kapena njira yowonjezereka ya mankhwala ingafunike.

Momwe mungapewere matenda?

Pofuna kupewa chitukuko cha acromegaly, madokotala amalangiza kutsatira malangizo otsatirawa.

Pewani kuvulala kwambiri pamutu,
chiritsani matenda opatsirana munthawi yake,
funsani dokotala zamatenda a metabolic,
Samalani matenda omwe amakhudza ziwalo zam'mapazi,
nthawi ndi nthawi mumayesa mayeso okula kwa mahomoni a prophylactic.

Acromegaly ndimatenda osowa komanso owopsa, atakhala ndi zovuta zingapo. Komabe, kudziwikiratu panthawi yake komanso momwe mungakwaniritsire, chithandizo chokwanira chitha kukwaniritsa chikhululukiro ndikubwezeretsa wodwalayo ku moyo wodziwa zonse!

Sovinskaya Elena, wowonera zachipatala

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